This invention relates to the diagnosis of human dental diseases and conditions by detection of microorganisms and cells associated therewith.
Dental diseases are quite prevalent in the United States and elsewhere. Perhaps 45 million adults suffer from destructive periodontal disease in the U.S., and perhaps 1 million children suffer from juvenile periodontitis. It can be estimated that 95% of the U.S. population suffers from dental caries at some point in life. There is a considerable need for diagnostic tools to allow a dentist to quickly and effectively detect the presence of these diseases and conditions, to aid and monitor treatment. This is especially true for juvenile periodontitis and dental caries, for which more specialized treatments exist.
Recent evidence suggests that different forms of periodontal disease have specific microbial etiologies. Actinobacillus actinomycetemcomitans has been well established to be a causative agent for juvenile periodontitis (J. Slots et al, Infect. Immun. 29: 1013-1020, 1980; Mandell and Socransky, J. Periodont. 52: 593-598, 1981). Actinobacillus actinomycetemcomitans, Bacteroides, gingivalis, Bacteroides intermedius, Fusobacterium nucleatum, Capnocytophaga ochracea, Selenomonas sputigena, Eikenella corrodens, Wolinella recta, spirochetes and fusiform Bacteroides are associated with, and implicated in the cause of, adult periodontal disease (Tanner et al., J. Clin. Periodont. 6:278-307, 1979; Dzink et al., J. Clin. Periodont. 9: in press 1985). In addition, leukocytes (white blood cells) are known to be present in periodontal pockets from patients suffering from periodontal disease (Listgarten & Hellden, J. Clin. Periodont. 5: 115, 1979; Keyes & Rams, J. Amer. Den. Svc. 106: 803, 1983). The presence of elevated levels of Streptococcus mutans in saliva samples is known to indicate a susceptibility to caries. (W. J. Loeche, et al., Infect. Immun. 21: 830, 1978).
One approach in diagnosing these medical disorders is to identify causative microorganisms by culturing and taxonomic identification of bacteria from samples from periodontal pockets. This approach is labor-intensive, and samples must be quickly and correctly handled to preserve their viability. Alternatively, assays for enzyme activities thought to be associated with causative organisms may be used. Various assays involving polyclonal or monoclonal antibodies have also been used. For example, Ebersole, U.S. Pat. No. 4,458,014, discloses a method for the serological identification of certain microorganisms from the oral cavity, in particular, black-pigmented Bacteroides. This method involves the preparation of polyclonal antibodies directed at these organisms by injection of killed cells into a mammal such as a rabbit, and recovery of antibodies from the mammal's serum. The polyclonal antibodies are used in a diagnostic protocol to detect organisms.